The technological tools and evolving knowledge encompassing Nursing Informatics (NI) are challenging us to expand our thinking, skills and ideology. NI is reshaping how we care for our patients including how we address their healthcare information needs. We must all focus our attention on ways to enhance patient care through the use of technology. The skill and fortitude of nurses will make NI come to life and be used in ways we have not even thought of as of yet!

Over 19 years ago, Mikuleky and Ledford (1987) began to write about NI capabilities and stated, “As they gain more knowledge of how computers and computer systems work nurses will think of more creative ways of using a computer to solve nursing problems” (p. 249). Nurses continue to stretch NI from documentation enhancements to complete online telecare. “As nurses make known their creative ideas for using them, the forces of the free enterprise system will insure that more programs are available. Nurses will become `computer smart` by using the computer daily in their jobs” (Mikuleky and Ledford, pp. 249-250). The computer was becoming a major force in nursing practice. This integration into the professional lives of nurses needed to be controlled by and evolved through the work of nurses. It was not suitable for IT departments to buy, create or add-on any software for nursing without having input from the nursing users. As nurses increased their savvy and began to gain expertise in the IT side of healthcare, the impact of nursing began to be realized. Nurses were hired to augment IT teams and help in the development of nursing tools. Nurses began to think of the computer as an enhancement rather than a burden as more and more nursing specific programs were generated that helped to save time and improve care. Mikuleky and Ledford looked toward nursing’s future when they wrote “Imagine if nurses became very involved in designing and programming nursing information systems” (p. 250). They believed that the future for nursing was very promising and exciting, “Technology is moving so fast that there is no way to predict how nurses will be using the computer as a tool for patient care in the next five years. But whatever evolves, the computer will remain an important nursing tool” (Mikuleky and Ledford, p. 251). This belief was reflected in Thede’s (1999) comment, “Nurses must think of the computer as a tool that is useful for identifying and solving problems” (p. 293). It is nurses’ comprehension and inventiveness that will drive the future development of technology tools that will integrate into and automate nursing practice.

Ball (2005) believes that “The nation is at a tipping point in applying enabling technologies to healthcare…. The time has come for healthcare to leave the manual tools of the past in the past and turn to the enablers of the 21st century” (p 19). Nurses have always been innovative advocates that fight to improve the health of their patients, families, communities, society and with the current technologies, globally. Our profession has never before had the far-reaching capabilities that we have afforded to us at this time. We can literally reach across continents and spread our message in nanoseconds. Time and distance have been removed as barriers to healthcare. Cox, Harsanyi and Dean (1987), recognized that “telecommunications is an up-and-coming use of computers that is important in business, educational and home applications” (p.51). As telecare, telehealth, telemedicine, telenursing, etc. are evolving, they have expanded our impact and are providing much needed care, information and support to patients, families, communities and societies that have been isolated and at times, forgotten. Patients can receive a high quality of care even though they are in underserved areas or even developing countries. As we increase the use of technology and decrease the use of touch, nursing must learn how to demonstrate caring without touching the patient. We can no longer equate touch with care. These new ways of caring will be technologically-based. The Telecare modality is a means to an end – quality patient care – even though it is at a distance. This is one of the newer frontiers we are exploring.

According to Ball (2005), “The nursing profession is being transformed to meet the needs of the new world and will be a major player in the revolution” (p 19). Nurses must find ways to facilitate the integration of all health care personnel data to provide a comprehensive plan of care. Ball believes that “These silos of information by discipline do not lead to the best care plan. Data generated by any one group that may be of interest to other groups should be integrated, easily accessible, and clearly visible as patient-centric information” (p 3). Thede (2003) stated the need for correct and comprehensive patient data as well as other embedded tools to facilitate patient care and envisions that this design, “will provide decision support, contain clinical reminders and alerts, and provide links to related knowledge bases. The use of one integrated patient record for each patient in today’s large healthcare enterprises is the first step in achieving this vision” (p. 320). This patient-centered care format will improve patient care through enhanced communication and coordination. Nurses must continue to proactively promote the use of technology to enhance patient care. It is through our commitment to our patients and our profession that we will harness the capabilities of the technological revolution and shape our new patient care frontiers with caring and compassion.

Please take some time to reflect on ways in which NI can improve the care that is provided in your setting while contemplating how to reach out to those who cannot access your skills. We must collectively drive the NI vehicle so that quality healthcare is afforded to those in need.